A decade into the formal adoption of the World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grading system for clear cell renal cell carcinoma (CCRCC) and papillary renal cell carcinoma (PRCC), newer grading concepts, innovative approaches and some issues have emerged. A comprehensive review of the literature on the WHO/ISUP grading system and other grading approaches for CCRCC and PRCC was conducted.